ekg 3 Flashcards
atrial enlargement
produced by increased atrial work or volume overload
ventricular enlargement
is caused by clinical conditions that increase workload of the ventricle or volume overload
right atrial enlargement on ECG
tall peaked P wave in inferior leads (II, III, aVF)
tall initial upstroke of the P wave in V1 and terminal negative deflection
causes of right atrial enlargement
usually associated with right ventricular enlargement
- pulmonary disease
acute: bronchial asthma, PE
chronic: emphysema, bronchitis
-congenital heart defects
ASD, pulmonic stenosis, ebstein’s anomaly, tetralogy of fallot
left atrial enlargement on ECG
notched M shape P wave in leads I, II and aVL
small initial upstroke of the P wave in V1 with deep terminal negative deflection
LAE think
mitral valve
p mitrale
P wave may be humped like an M
RAE think
p pulmonale
think pulmonary
tall and peaked p waves
right ventricular hypertrophy on EKG
right axis deviation
I and aVF -thumb
r wave in lead V1 exceeds the depth of S wave
RV strain pattern:
-T wave inversions with possible ST depression in leads V1 and V2
left ventricular hypertrophy ECG
left axis deviation
depth of S wave in V1 or V2 plus the height of R wave in V5 or V6 > 35 mm
right bundle branch block
QRS greater than 0.12 sec
V1 rSR pattern with final R wave (Big M wave)
V6 qRS pattern with final wide S wave
left bundle branch block
V1 QS pattern greater than 0.12 seconds
V6 wide tall R wave
inverted T waves in leads I aVL, V5 and V6
bundle branch turn signal method*
ONLY WORKS IN V1
go to j point at the end of QRS
draw a straight line into the QRS
connect this line with the peak or vally of the QRS complex
OBSERVE the direction the triangle points
down: LBBB
up: RBB
INVERT -causes of T wave inversion
I: ischemia and injury N: normal variant V: ventricular hypertrophy E: ectopic foci (calcified plaque) R: right and left bundle branch block T: treatment (digitalis)
DEPRESSED ST- causes of ST segment depression
D: drooping mitral (prolapse) E: enlargement of LV P: potassium loss R: reciprocal ST depression in AMI E: embolism in lungs S: subendocardial ischemia S: subendocardial infarct E: encephalon hemorrhage D: dilated cardiomyopathy S: shock T: treatments
Causes of ST segment elevation
E: electrolytes L: LBBB E: early repolarization V: ventricular hypertrophy A: aneurysm (ventricular) T: treatment (pericardiocentesis) I: injury (AMI, cardiac contusion) O: osborne wave (hypothermia) N: non-occlusive vasospasm (prinzmetal)
